Introduction:How to reconstruct fingertip injury with partial defect of nailbed and skin is a clinical problem. Our team design the hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein to reconstruct fingertip injury with partial defect of nailbed and skin for a long time. Thus, we perform the retrospective study to evaluate the effects of this technique on fingertip injury with partial defect of nailbed and skin.
Materials and methods:A retrospective analysis was performed on 40 patients with fingertip injury with partial defect of nailbed and skin admitted to our hospital from January 2016 to January 2020 who were treated by the hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein. During the follow-up, we recorded the operation time, intraoperative blood loss, the size of the transplanted flap, complications, the survival rate of the transplanted flap, total nail growth time, Semmes-Weinstein evaluating tactile sensation, two-point discrimination testing (TPD) and observed the appearance of reconstructed fingertip.
Results:The operation time was (3.62±0.47) hours, the intraoperative blood loss was (31.77±4.54) ml, the size of transplanted flap was 12 mm × 7 mm to 19 mm × 10 mm, the survival rate of the transplanted flap was 100%. During the (26.82±4.47) months follow-up, the total nail growth time was (9.14±1.78) months and there is no complications. The average tactile sensation evaluated by the Semmes-Weinstein test and the average TPD of reconstructed fingertip was (0.31±0.15) g and (7.26±1.26) mm separately. The reconstructed fingertips had beautiful appearance and walking function of foots providing flaps was not influenced.
Conclusions:The hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein transplantation is an effective method to reconstruct fingertip injury with partial defect of nailbed and skin with a beautiful appearance and excellent function.
Type of study/level of evidence Therapeutic IV.